Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > module 15-17 > Flashcards

module 15-17 Flashcards

1
Q

what is diabetes?

A

a chronic disease - elevated blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what happens to the urine in untreated diabetes?

A

the transporters in the proximal tubule that normally reabsorb all the glucose, are saturated which results in significant amts of glucose in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why do people have high blood sugar (diabetes)?

A

Either because not enough insulin produced or because the body’s cells do not respond to the insulin that is produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the classic symptoms of diabetes?

A

polydipsia (increased thirst), polyuria (increased urination), polyphagia (increased hunger) & weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is insulin?

A
  • peptide hormone synth by beta cells of the islets of langerhans in the pancreas
  • rapidly released into blood in response to increases in blood glucose
  • it causes uptake of glucose into cells (muscle, liver, & fat)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what happens to glucose once taken up by liver cells?

A

glycogen synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what happens to glucose once taken up by muscle cells?

A

used as energy & promotes protein synth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens to glucose once taken up by fat cells?

A

increased synth of fatty acids, results in increased triglyceride synth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what other molecule is important to the action of insulin in driving glucose uptake by cell?

A

extracellular potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the types of diabetes?

A

Type I
Type II
Gestational

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what percentage of people with diabetes have Type I?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some of the features of type I diabetes?

A
  • usually diagnosed in children or adolescents
  • autoimmune reaction - beta cells destroyed
  • body makes too little or no insulin & requires insulin replacement
  • not preventable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what percentage of people with diabetes have Type II?

A

90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some of the features of type II diabetes?

A
  • pancreas makes sufficient insulin, however, the insulin produced is resistant to use
  • over the course of the disease insulin synth may be reduced
  • typically diagnosed later in life but trend toward younger people getting it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the risk factors for type II?

A

age, genetics, previous gestational, lack of exercise, obesity, ethnicity (African/Native increased risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are some of the features of gestational diabetes?

A
  • usually begins halfway through pregnancy
  • diet and exercise sufficient to keep blood glucose levels within normal ranges
  • tend to have larger babies & babies with hypoglycemia within first few days of life
  • the mother can develop diabetes 5-10 years later
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is diabetic retinopathy?

A
  • a complication of diabetes
  • most common cause of blindness in people under the age of 65
  • hyperglycemia causes damage to retinal capillaries
  • type I & type II should have eye exam 1x/year
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is diabetic nephropathy?

A
  • characterized by proteinuria (protein in the urine) [earliest sign of diabetic nephropathy], decreased glomerular filtration, increased BP
  • ACE inhibitors & ARBs are useful in prevention - pt.s with type I should take one of these regardless of BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diabetic nephropathy is the leading cause of…

A

morbidity & mortality in pts. with type I diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the connection between cardiovascular disease (CVD) and diabetes?

A
  • leading causes of morbidity & mortality in type II diabetics
  • atherosclerosis develops much earlier in those with diabetes compared to those without
  • results from combo if hyperglycemia & altered lipid metabolism
  • statins reduce cardiovascular events in diabetic pt.s regardless of LDL cholesterol levels
21
Q

what’s the deal with diabetic foot ulcers?

A
  • most common cause of hospitalization for diabetic patients
  • diabetes accounts for approx. half of all lower limb amputations every year due to infection
  • all diabetic should have regular foot exams
22
Q

what are the tests used to diagnose diabetes?

A
  1. Fasting plasma glucose test
  2. Casual Plasma glucose test
  3. oral glucose tolerance test (OGTT)
23
Q

what are the details of the fasting plasma glucose test?

A
  • pt.s fast for 8 hrs then have blood sample drawn to measure blood glucose
  • Preferred test for diagnosing
24
Q

what are the details of the casual plasma glucose test?

A
  • blood drawn at any time

* if initial test suggests diabetes, f/u with fasting plasma glucose test

25
Q

what are the details of the oral glucose tolerance test?

A
  • used when other testes unable to definitively diagnose diabetes
  • pts. given 75 g dose of glucose & plasma glucose is measured 2 hrs later
26
Q

what’s the deal with glycosylated hemoglobin?

A

upon prolonged exposure in the blood, glucose interacts with hemoglobin to form glycosylated derivatives, mostly HbA1c

  • measuring this is a poor diagnostic tool but is useful for providing index of avg. glucose levels over the previous 2-3 mths
  • also measuring it is a good determinant of how pt. responding to therapy
  • target: maintain HbA1c less than 7% of total hemoglobin
27
Q

what is the primary goal of diabetes therapy?

A

maintain tight control of plasma glucose levels (normal range)

28
Q

due to risk of cardiovascular disease what should be monitored in diabetics?

A

BP
LDL
triglycerides
HDL

29
Q

what is the target to keep in mind for kidney function in those with diabetes?

A

urine albumin to creatinine ratio

30
Q

what does it mean that insulin can be thought of as anabolic?

A

-“building up” or conservative
-promotes energy storage & conservation
-insulin’s anabolic actions include:
uptake of glucose liver, muscle, fat
results in formation of glycogen & triglycerides
decreased gluconeogenesis
cellular uptake of amino acids (mostly muscle) resulting in protein synth

31
Q

what happens re: metabolic processes when there is an insulin deficiency?

A

puts body in catabolic state (breaking down)
body favours breaking down complex molecules into simpler substances
catabolic effects include:
glycogenolysis - conversion of glycogen to glucose
gluconeogenesis - new glucose synth
decreased glucose utilization

*all these contrib to signs and symptoms of diabetes & they all act to raise blood glucose

32
Q

what are the types of insulin?

A

short duration-rapid acting
short duration-slower acting
intermediate duration
long duration

33
Q

talk about mixing insulins

A

sometimes combo of short acting with longer acting
mix in single syringe
Rules:
only NPH can be mixed with short acting insulins
draw short acting first
mixtures are stable for 28 days

34
Q

what are complications of insulin therapy?

A

primary complication is hypoglycemia (

35
Q

how do you manage hypoglycemia?

A

requires rapid tx to prevent irreversible brain damage
conscious - oral sugar (glucose tablets, orange juice, corn syrup, honey and pop)
unconscious - IV glucose
*it’s also recommended that diabetic patients keep hormone glucagon on hand

36
Q

how is glucagon used to treat hypoglycemia?

A

usually in the community when a patient it unconsious - injected

  • IV glucose is preferred for unconscious pt.s but impractical in the community
  • also not effective in starving or malnourished pts. as they will have little to no stores of glycogen
37
Q

what are the different types of oral antidiabetic drug?

A

these are for type II diabetics

biguanides
sulfonylureas
meglitinides
thiazolidinediones (glitazones)
alpha-glucosidase inhibitors
gliptins
38
Q

what are virulence factors of bacteria?

A

fimbriae and pilli (eg. e.coli have fimbriae - cause bladder infections)
flagella
secretion of toxins and enzymes (food poisoning - colonize & secrete toxins into foods)
invasion (bacteria that cause TB hide in lung cells)

39
Q

what is gram staining?

A

a technique used to classify bacteria as gram + or gram -

why? gram stain tells us which antibiotic will be effective

40
Q

what are characteristics of gram + bacteria?

A

purple stain
thick peptifoglycan wall
techoic acids (provide rigidity to wall, major surface antigen)

41
Q

what are characteristics of gram - bacteria?

A

pink stain
thin petidoglycan layer
lipopolysaccharides (LSPs) - a structural component of the outer membrane and the major surface antigen
Outer membrane - protects gram - bacteria from bile salts & detergents
Porins - on outer membrane, allow certain sugars, ions, and amino acids to enter bacteria

42
Q

signs of infection?

A 
fever *not always
overall malaise
local redness
swelling
increased RR
tachycardia

*babies may have immature hypothalamus or elderly may have decreased hypothalamic function therefore no fever

43
Q

how does antibiotic produce selective toxicity?

A
  • disrupting cell wall (human cells don’t have one)
  • targeting enzymes that are unique to bacteria
  • disrupting bacteria protein synthesis (ribsomes are different)
44
Q

what does bacteriostatic mean?

A

that an antibiotic stops the growth and replication of bacteria and therefore stops the spread of infection
-the body’s immune system can then attack & remove the bacteria

45
Q

what does bactericidal mean?

A

antibiotics kill the bacteria

46
Q

what does MIC & MBC mean?

A

MIC - minimum inhibitory concentration - concentration required to stop growth & replication
MBC - minimum bactericidal concentration - min concentration required to kill

*microbiologists can culture bacteria to find out the MIC & MBC of antibiotics

47
Q

what are types of infections that are difficult to treat?

A 
meningitis
UTI
osteomyelitis
abscesses
otitis media
48
Q

what type of antibiotic should be used for pt.s with compromised immune system?

A

bactericidal
as the bacteriostatic ones still require the person’s immune system to do work
ppl with AIDS, organ transplantation, cancer chemo, elderly

49
Q

what are potential complication of antibiotic therapy?

A 
resistance
allergy
serum sickness
superinfection
destruction of normal bacterial flora
bone marrow toxicity

Pharmacology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions